Section Name Field Name Field and/or Section Description
ACORD 50 WV, West Virginia Certificate of Insurance, was created in response to West Virginia regulations. The main differences between the generic ACORD Automobile Insurance Card, ACORD 50, and the West Virginia card are:
* The plate number must be shown in the upper right corner of the front of the card.
* The front of the card includes a statement referring to an authorized insurer who has issued a policy in accordance with West Virginia law.
* If the owner and the insured are different, both names must be shown.
* The owner must sign the form.
* Two cards must be issued to the insured. One should be retained in the insured
TITLE ACORD 50 WV (2008/04) West Virginia Certificate of Insurance vehicle, and the other used to provide proof of insurance at the time license plates are purchased.
INSURANCE
IDENTIFICATION CARD Check box - Commercial Check this box if the vehicle is insured under a commercial policy.
INSURANCE
IDENTIFICATION CARD Check box - Personal Check this box if the vehicle is insured under a personal policy.
INSURANCE This space is provided for the owner of the vehicle to enter the license plate number of the
IDENTIFICATION CARD Vehicle Owner Enter Plate # insured vehicle.
INSURANCE The Company Number that must be shown on the card is the NAIC number for the
IDENTIFICATION CARD Company Number individual company issuing the policy.
INSURANCE Name of the applicable insurance company. Use the actual name of the company within
IDENTIFICATION CARD Company the group to which the policy has been issued. Do not use group names.
INSURANCE
IDENTIFICATION CARD Policy Number Number exactly as it appears on the policy, including prefix and suffix symbols.
INSURANCE
IDENTIFICATION CARD Effective Date Enter the effective date shown in the policy.
INSURANCE
IDENTIFICATION CARD Expiration Date Enter the expiration date shown in the policy.
INSURANCE
IDENTIFICATION CARD Year Year of the motor vehicle.
INSURANCE
IDENTIFICATION CARD Make/Model Make and Model of the motor vehicle.

ACORD 50 WV (2008/04) 1 of 2 ACORD 50 WV (2008/04) 2 of 2

Section Name Field Name Field and/or Section Description
INSURANCE IDENTIFICATION CARD Vehicle Identification Number Vehicle Identification Number of the motor vehicle.
INSURANCE IDENTIFICATION CARD Insured Name of the insured as found on the declarations page of the policy.
INSURANCE IDENTIFICATION CARD Owner Name of the owner if different from the insured.
INSURANCE IDENTIFICATION CARD Agency/Company Issuing Card Name of the issuing agency or company.
INSURANCE IDENTIFICATION CARD Date Issued Enter the date card was issued
INSURANCE IDENTIFICATION CARD Signature of Owner Owner must sign the form.
INSURANCE IDENTIFICATION CARD Date Date Owner signed the form.